Truman Medical Centers achieves all of their financial Medical Centers, MO Truman Medical Centers...

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Seth Jeremy Katz, MPH RHIA Associate Administrator, Information Management Truman Medical Centers, MO

Truman Medical Centers achieves all of their financial targets in less than 6 months with CDI 3D

Financial Considerations

3 Confidential property of Optum360. Do not distribute or reproduce without express permission from Optum360.


CMI Trends


Fiscal Snapshot


Our Vision “Leading the way to a healthy community”

TMC Hospital Hill

*Fiscal Year June 2015

TMC Lakewood

$120,000,000 uncompensated care

2 hospitals / 600 Beds (acute, LTC, psych)

51 clinics (primary care and specialty)

Academic medical center supporting UMKC School of Nursing, Medicine, Dentistry and Pharmacy

Level one trauma center

577 medical staff / 235 residents

4,000 employees

19,908 acute care admissions

2,722 behavioral health admissions

3,708 births

338,190 outpatient visits

278,913 behavioral health outpatient visits

97,729 ED visits


Mission and Recognition

Mission TMC is an academic health center providing accessible, state-of-the-art quality health care to our

community regardless of the ability to pay.

Recognition

2011-2015 by Hospitals and Health

Networks Magazine

Dual HIMSS Stage 7 accreditation for both inpatient

and outpatient settings across both TMC facilities

AHIMA 2013 Grace Award

CHIME-AHA Transformational Leadership Award

Level III Patient-Centered Medical Home

National Committee for Quality Assurance (NCQA)

2014 HIMSS Enterprise Davies Award Recipient


The Action Plan

Move CDI under HIM to better align objectives

Implement software that is integrated with the EMR and is

an all-in-one solution

Choose a partner willing to put skin-in-the-game

Must be able to provide CDI impact on a case-by-case basis


Key Metrics

Improvements • CMI improvements on DRG

based payors • Medicare • Blue Cross Blue Shield • United Healthcare

• Physician response rate • Increase in CC/MCC capture • Improved cash flow • Increased number of queries

Diminishing • Inability to track results • Decrease in physician no

responses • Eliminate multiple

application use by CDI team


The Holy Grail: The Bi-Directional Query


1

1) CDIS reviews the account in Optum for potential query opportunities

2) CDIS resolves (if necessary) any markers

3) Queries created in application and edited for content to add or remove elements

4) Query sent to EMR via bi-directional interface, no cutting or pasting of text between systems


Physician Inbox


Physician View of the Query

1


Medical Record Review: Physician Queries

1


Closing The Loop


TMC Query Response Rates

Truman Medical Center CDI Data Summary Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16

$82,372 $257,303 $332,393 $594,356 $1,054,199 $1,431,689 Physician Query Data

Total Distinct Accounts with Queries 56 100 163 222 199 218 Total Queries Sent 86 180 263 351 319 342 Responded 83 157 198 310 311 310 Total Query Agrees 65 122 129 229 228 247 Total Query Declines 17 31 59 64 71 51 No Response 3 23 65 40 5 23 Remaining Open Queries 1 4 10 18 15 21 Physician Response% 96.51% 87.22% 75.29% 88.32% 97.49% 90.64% Physician Agree% 78.31% 77.71% 65.15% 73.87% 73.31% 79.68%

Prior to go live Physician query data

Query Outcome July August MD Agree 43% 57% No Response 35% 41%


32K

1.09 1.14

1.05

1.24

1.29 1.30

1.47

1.17

0.80

0.90

1.00

1.10

1.20

1.30

1.40

1.50

1.60

Sept Oct Nov Dec Jan Feb Mar CMIBase

Lakewood

Change in Medicare FFS Dollars Based on CMI

CI Initiative Dec Jan Feb Mar Dec

49K

47K

Total: $155K

27K


What Do You Think?

Seth Jeremy Katz, MPH, RHIA [email protected]

816-404-3355

Truman Medical Centers achieves all of their financial Medical Centers, MO Truman Medical Centers...

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